NSG 552 Psychopharmacology
Exam Question Bank
Exams 1, 2 & 3
150 multiple-choice questions with answers and rationales
Exam 1 (Questions 1–50): Neurobiology, pharmacokinetics and
pharmacodynamics, CYP450, and antidepressants
Exam 2 (Questions 1–50): Mood stabilizers, anxiolytics,
sedative-hypnotics, and ADHD medications
Exam 3 (Questions 1–50): Antipsychotics, special populations,
substance use disorders, dementia, and psychiatric emergencies
NSG 552 Exam Question Bank – Page 1
,EXAM 1
Topics: Neurobiology, pharmacokinetics and pharmacodynamics,
CYP450, and antidepressants
1. Which neurotransmitter is most closely associated with
the brain's reward pathway and is a primary target of
stimulant medications?
A. Dopamine
B. GABA
C. Acetylcholine
D. Glutamate
Answer: A. Dopamine
Rationale: Dopamine projecting from the ventral tegmental area
to the nucleus accumbens (mesolimbic pathway) drives reward
and reinforcement. Stimulants increase synaptic dopamine and
norepinephrine, which explains both their therapeutic effect and
their abuse potential.
2. Hyperactivity of the mesolimbic dopamine pathway is most
closely associated with which symptom domain in
schizophrenia?
A. Negative symptoms such as alogia and avolition
B. Cognitive deficits such as impaired working memory
C. Elevated prolactin with galactorrhea
D. Positive symptoms such as hallucinations and delusions
Answer: D. Positive symptoms such as hallucinations and
delusions
Rationale: Excess mesolimbic dopamine is linked to positive
symptoms, which is why D2 blockade reduces them. Negative
and cognitive symptoms are linked to reduced dopamine in the
NSG 552 Exam Question Bank – Page 2
,mesocortical pathway, and hyperprolactinemia results from D2
blockade in the tuberoinfundibular pathway.
3. Reduced dopamine activity in the mesocortical pathway is
believed to contribute to which clinical presentation?
A. Acute dystonia
B. Positive symptoms of schizophrenia
C. Negative and cognitive symptoms of schizophrenia
D. Hyperprolactinemia
Answer: C. Negative and cognitive symptoms of
schizophrenia
Rationale: Low prefrontal dopamine activity is associated with
negative and cognitive symptoms, and D2 blockade in this
pathway can worsen them (secondary negative symptoms). Acute
dystonia arises from nigrostriatal blockade and
hyperprolactinemia from tuberoinfundibular blockade.
4. Which neurotransmitter is the major inhibitory
neurotransmitter of the central nervous system?
A. Glutamate
B. GABA
C. Norepinephrine
D. Dopamine
Answer: B. GABA
Rationale: Gamma-aminobutyric acid (GABA) opens chloride
channels and hyperpolarizes neurons. Benzodiazepines, Z-drugs,
barbiturates, and neuroactive steroids such as zuranolone
enhance GABA-A activity. Glutamate is the major excitatory
neurotransmitter.
NSG 552 Exam Question Bank – Page 3
, 5. Ketamine and esketamine produce rapid antidepressant
effects primarily through which mechanism?
A. Positive allosteric modulation of the GABA-A receptor
B. Antagonism of the NMDA glutamate receptor
C. Partial agonism of the 5-HT1A receptor
D. Antagonism of the alpha-2 adrenergic receptor
Answer: B. Antagonism of the NMDA glutamate receptor
Rationale: Ketamine and esketamine block NMDA receptors,
leading to a glutamate surge, AMPA receptor activation, and rapid
synaptogenesis. GABA-A modulation is the mechanism of
zuranolone and brexanolone.
6. Which amino acid is the dietary precursor for the
synthesis of serotonin?
A. Tryptophan
B. Tyrosine
C. Phenylalanine
D. Glutamine
Answer: A. Tryptophan
Rationale: Tryptophan is converted to 5-hydroxytryptophan by
tryptophan hydroxylase (the rate-limiting step) and then to
serotonin. Tyrosine is the precursor of dopamine and
norepinephrine.
NSG 552 Exam Question Bank – Page 4
Exam Question Bank
Exams 1, 2 & 3
150 multiple-choice questions with answers and rationales
Exam 1 (Questions 1–50): Neurobiology, pharmacokinetics and
pharmacodynamics, CYP450, and antidepressants
Exam 2 (Questions 1–50): Mood stabilizers, anxiolytics,
sedative-hypnotics, and ADHD medications
Exam 3 (Questions 1–50): Antipsychotics, special populations,
substance use disorders, dementia, and psychiatric emergencies
NSG 552 Exam Question Bank – Page 1
,EXAM 1
Topics: Neurobiology, pharmacokinetics and pharmacodynamics,
CYP450, and antidepressants
1. Which neurotransmitter is most closely associated with
the brain's reward pathway and is a primary target of
stimulant medications?
A. Dopamine
B. GABA
C. Acetylcholine
D. Glutamate
Answer: A. Dopamine
Rationale: Dopamine projecting from the ventral tegmental area
to the nucleus accumbens (mesolimbic pathway) drives reward
and reinforcement. Stimulants increase synaptic dopamine and
norepinephrine, which explains both their therapeutic effect and
their abuse potential.
2. Hyperactivity of the mesolimbic dopamine pathway is most
closely associated with which symptom domain in
schizophrenia?
A. Negative symptoms such as alogia and avolition
B. Cognitive deficits such as impaired working memory
C. Elevated prolactin with galactorrhea
D. Positive symptoms such as hallucinations and delusions
Answer: D. Positive symptoms such as hallucinations and
delusions
Rationale: Excess mesolimbic dopamine is linked to positive
symptoms, which is why D2 blockade reduces them. Negative
and cognitive symptoms are linked to reduced dopamine in the
NSG 552 Exam Question Bank – Page 2
,mesocortical pathway, and hyperprolactinemia results from D2
blockade in the tuberoinfundibular pathway.
3. Reduced dopamine activity in the mesocortical pathway is
believed to contribute to which clinical presentation?
A. Acute dystonia
B. Positive symptoms of schizophrenia
C. Negative and cognitive symptoms of schizophrenia
D. Hyperprolactinemia
Answer: C. Negative and cognitive symptoms of
schizophrenia
Rationale: Low prefrontal dopamine activity is associated with
negative and cognitive symptoms, and D2 blockade in this
pathway can worsen them (secondary negative symptoms). Acute
dystonia arises from nigrostriatal blockade and
hyperprolactinemia from tuberoinfundibular blockade.
4. Which neurotransmitter is the major inhibitory
neurotransmitter of the central nervous system?
A. Glutamate
B. GABA
C. Norepinephrine
D. Dopamine
Answer: B. GABA
Rationale: Gamma-aminobutyric acid (GABA) opens chloride
channels and hyperpolarizes neurons. Benzodiazepines, Z-drugs,
barbiturates, and neuroactive steroids such as zuranolone
enhance GABA-A activity. Glutamate is the major excitatory
neurotransmitter.
NSG 552 Exam Question Bank – Page 3
, 5. Ketamine and esketamine produce rapid antidepressant
effects primarily through which mechanism?
A. Positive allosteric modulation of the GABA-A receptor
B. Antagonism of the NMDA glutamate receptor
C. Partial agonism of the 5-HT1A receptor
D. Antagonism of the alpha-2 adrenergic receptor
Answer: B. Antagonism of the NMDA glutamate receptor
Rationale: Ketamine and esketamine block NMDA receptors,
leading to a glutamate surge, AMPA receptor activation, and rapid
synaptogenesis. GABA-A modulation is the mechanism of
zuranolone and brexanolone.
6. Which amino acid is the dietary precursor for the
synthesis of serotonin?
A. Tryptophan
B. Tyrosine
C. Phenylalanine
D. Glutamine
Answer: A. Tryptophan
Rationale: Tryptophan is converted to 5-hydroxytryptophan by
tryptophan hydroxylase (the rate-limiting step) and then to
serotonin. Tyrosine is the precursor of dopamine and
norepinephrine.
NSG 552 Exam Question Bank – Page 4
